High flow priapism after blunt perineal trauma: resolution with bucrylate embolization

We report on 2 patients (ages 21 and 33 years) with high flow priapism secondary to arteriocavernous fistula produced by perineal injury. Both cases were satisfactorily resolved by super-selective embolization of the fistula with bucrylate. Diagnosis was based on the results of gasometry in cavernous blood, color Doppler ultrasound and arteriography. Erectile function after 24 and 30 months of treatment, respectively, was normal in both patients. Review of the literature revealed that only 13 patients have been managed with arterial embolization. To our knowledge our report represents the first in which intracavernous bucrylate embolization produced detumescence with preservation of erectile function.